International Clinical Cancer Trials
What are trials?
Cancer treatments are improving. Breast Cancer is found earlier and often cured with smaller surgery. Survival after bowel cancer and melanoma is improving. These advances have a single connection – they were established through large scale trials in which fully informed cancer sufferers volunteered to use new treatments. The size of a trial is important for dependable results. The problem is that for a single hospital to collect enough patients could take ten years. Collaborative trials involving tens or sometimes hundreds of hospitals and thousands of patients provide reliable answers quickly.
Why trials in the South West?
Traditionally these trials were run by metropolitan teaching hospitals. In 2003, the Cancer Council of Western Australia and WACOG (West Australian Clinical Oncology Group) asked the Lishman Health Foundation to attempt to bring trials to a regional centre, as a possible model for other centres to use. After more than a year of accreditation and approval processes, the trials commenced.
The process starts with government-funded bodies, such as the NHMRC, commissioning world experts to collaborate and select the best research ideas. A lead institution, usually a big hospital, is then invited and funded to turn these ideas into detailed instructions, so that the many participating hospitals actually doing the research will use identical procedures. Participating hospitals must reach international standards before accreditation to trials and are audited during trials. Rigorous ethics protect patients who volunteer to enter a trial. Trials end immediately if one treatment proves better than the other.
Patients and trials
Patients can only join a trial if they meet eligibility criteria. For instance, people with a second serious illness might not be suitable. If suitable patients are interested in a trial, they receive full information on standard treatments and the new method of treatment. They are encouraged to go away to think about it and ask questions before being admitted to the trial. The actual treatment given is then selected by chance, to avoid bias in allocating treatments.
With treatment finished, regular and intensive after care makes sure all the advantages and disadvantages of both treatments are fully recorded. All results are relayed to the trial organisers, who in turn provide progress reports until the research question have been fully answered.
Patients have the satisfaction of knowing that their treatment is at the cutting edge of medical knowledge, while contributing to world progress in cancer treatment. Many find this an empowering experience.
Trials in the South West region commenced at St John of God Health Care Medical Centre, South West Health Campus in March 2004. With feasibility established, the Foundation retired from the project in 2011.